Essay About Community Health Improvement Services And Hospitalscommunity Benefit Measure        Charity Care

Methodology
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While the empirical evidence concerning the impact of not-for-profit ownership on quality and efficiency is ambiguous, there is evidence that not-for-profit hospitals provide more uncompensated care and more unprofitable services than for-profit hospitals. Yet the magnitude of this difference is not large enough to justify the granting of tax-exempt status to not-for-profit hospitals even though the absolute level of uncompensated care in about 80 percent of not-for-profit hospitals exceeds the value of the hospital’s tax exemption1.Private tax-exempt hospital Data sources: Form 990, year 2009Sample size ~ 1800 hospitalsCommunity benefit measure        Charity care        Unreimbursed costs for means-tested government program        Subsidized health services (services provided at a financial loss)        Community health improvement services and community-benefit operations        Research        Health-professions education        Financial and in-kind contributions to community groupsAnalytic model = entails combining seven community benefit measure into two distinct community benefit variables: added together the reported contributions of a hospital for those measures pertaining to direct patient care – namely, charity care, unreimbursed costs for means-tested programs, and subsidized health services. PATIENT CAREadded together the reported contributions for the remaining measures pertaining to broader community service. COMMUNITY SERVICEStatistical analysis: use descriptive statistics for each of the community benefit measureMean percentage of operating expensesStandard deviationInterquartile range Analytic model: use two multiple-regression models, one for each type of community benefit measure, using generalized linear model Regression model:        Independent variables:institutional-level: motivation of the hospital to provide community benefits and its capability to do socommunity-level, market-level characteristics: the need for community benefit, and potential supply of community benefits (of that hospital in county)the level of competitive pressures that tax-exempt hospitals face (such pressure may cause them to curtail their provision of community benefits2.Nonprofit hospital status as a corporately owned tax-exempt hospitalHospital’s willingness to supply community benefits        Teaching status        Size (beds)